Obesity in the United States

Obesity in the United States is a major health issue, resulting in numerous diseases, specifically increased risk of certain types of cancer, coronary artery disease, type 2 diabetes, stroke, as well as significant increase in early mortality and economic costs. While many industrialized countries have experienced similar increases, obesity rates in the United States are the highest in the world.[1]

An obese person in America incurs an average of $1,429 more in medical expenses annually. Approximately $147 billion is spent in added medical expenses per year within the United States. This number is suspected to increase approximately $1.24 billion per year until the year 2030.[2]

The United States had the highest rate of obesity within the OECD grouping of large trading economies.[3] From 23% obesity in 1962, estimates have steadily increased. The following statistics comprise adults age 20 and over. The overweight percentages for the overall US population are higher reaching 39.4% in 1997, 44.5% in 2004,[4] 56.6% in 2007,[5] and 63.8% (adults) and 17% (children) in 2008.[6][7] In 2010, the Centers for Disease Control and Prevention (CDC) reported higher numbers once more, counting 65.7% of American adults as overweight, and 17% of American children, and according to the CDC, 63% of teenage girls become overweight by age 11.[8] In 2013 the Organisation for Economic Co-operation and Development (OECD) found that 57.6% of American citizens were overweight or obese. The organization estimates that 3/4 of the American population will likely be overweight or obese by 2020.[9] 2014 figures from the CDC found that more than one-third (36.5%) of U.S. adults age 20 and older[10] and 17% of children and adolescents aged 2–19 years were obese.[11] A second study from the National Center for Health Statistics at the CDC showed that 39.6% of US adults age 20 and older were obese as of 2015-2016 (37.9% for men and 41.1% for women).[12]

Obesity has been cited as a contributing factor to approximately 100,000–400,000 deaths in the United States per year[13] and has increased health care use and expenditures,[14][15][16][17] costing society an estimated $117 billion in direct (preventive, diagnostic, and treatment services related to weight) and indirect (absenteeism, loss of future earnings due to premature death) costs.[18] This exceeds health care costs associated with smoking[17] and accounts for 6% to 12% of national health care expenditures in the United States.[19]

Prevalence

The National Center for Health Statistics estimates that, for 2015-2016 in the U.S., 39.8% of adults aged 20 and over were obese (including 7.6% with severe obesity) and that another 31.8% were overweight.[20]

Obesity rates have increased for all population groups in the United States over the last several decades.[13] Between 1986 and 2000, the prevalence of severe obesity (BMI ≥ 40 kg/m2) quadrupled from one in two hundred Americans to one in fifty. Extreme obesity (BMI ≥ 50 kg/m2) in adults increased by a factor of five, from one in two thousand to one in four hundred.[21]

There have been similar increases seen in children and adolescents, with the prevalence of overweight in pediatric age groups nearly tripling over the same period. Approximately nine million children over six years of age are considered obese. Several recent studies have shown that the rise in obesity in the US is slowing, possibly explained by saturation of health-oriented media or a biological limit on obesity.[21]

Race

ObesitySexRace
Rates of obesity in US by race.

Obesity is distributed unevenly across racial groups in the United States.[22]

Caucasian

The obesity rate for Caucasian adults 18 years and older (over 30 BMI) in the US in 2015 was 29.7%.[23] For adult Caucasian men, the rate of obesity was 31.1% in 2015.[24] For adult Caucasian women, the rate of obesity was 27.5% in 2015.[24] The most recent statistics from the NHANES of age adjusted obesity rates for Caucasian adults 20 years and older in the U.S. in 2016 was 37.9%.[25] The obesity rates of Caucasian males and Caucasian females from the NHANES 2016 data were relatively equivalent, obesity rates were 37.9% and 38.0%, respectively.[26] This large jump in obesity rate could possibly be attributed to the fact when teenagers of 18 and 19 years old are classified as adults instead of adolescents, their much lower rates of obesity skew and bring down the adult average.

Black or African American

The obesity rate for Black adults 18 years and older (over 30 BMI) in the US in 2015 was 39.8%.[23] For adult Black men, the rate of obesity was 34.4% in 2015.[24] For adult Black women, the rate of obesity was 44.7% in 2015.[24] The most recent statistics from the NHANES of age adjusted obesity rates for Black adults 20 years and older in the U.S. in 2016 was 46.8%. [25] According to the obesity rates of from the NHANES 2016 data, Black males had significantly lower than Black females, their rates were 36.9% and 54.8%, respectively.[26] BMI is not a good indicator in determining all-cause and coronary heart disease mortality in black women compared to white women.[27] This is perhaps caused by the fact that black females tend to have less body fat, especially visceral fat, for a given BMI or waist measurement than both White and Latina women.[28]

American Indian or Alaska Native

The obesity rate for American Indian or Alaska Native adults (over 30 BMI) in the US in 2015 was 42.9%.[23] No breakdown by sex was given for American Indian or Alaska Native adults in the CDC figures.[23]

Asian

The obesity rate for Asian adults 18 years and older (over 30 BMI) in the US in 2015 was 10.7%.[23] No breakdown by sex was given for Asian adults in the CDC figures.[23] In more recent statistics from the NHANES in 2016 of a breakdown by sex was provided. Asian adults 20 years and older had a total obesity rate of 12.7%. The rate among Asian males was 10.1% and among Asian females it was 14.8%. Asian Americans have substantially lower rates of obesity than any other racial or ethnic group. Notably, however, there is discussion that Asians should have a lower BMI cut-off for obesity than other races/ethnicities since they have higher health risks at a lower BMI.[25][26]

Hispanic or Latino

The obesity rate for the Hispanic or Latino adults 18 years and older category (over 30 BMI) in the US in 2015 was 31.8%.[23] For the overall Hispanic or Latino men category, the rate of obesity was 31.6% in 2015.[24] For the overall Hispanic or Latino women category, the rate of obesity was 31.9% in 2015.[24] According to the most recent statistics from the NHANES in 2016 Latino adults had the highest overall obesity rates. Latino Adults age 20 and older had reached an obesity rate of 47.0%.[25] Adult Latino men’s rate was 43.1%, the highest of all males. For adult Latina women the rate was 50.6%, making them second to African-American women.[26]

Mexican or Mexican Americans

Within the Hispanic or Latino category, obesity statistics for Mexican or Mexican Americans were provided, with no breakdown by sex.[23] The obesity rate for Mexican or Mexican Americans adults (over 30 BMI) in the US in 2015 was 35.2%.[23]

Native Hawaiian or Other Pacific Islander

The obesity rate for Native Hawaiian or Other Pacific Islander adults (over 30 BMI) in the US in 2015 was 33.4%.[23] No breakdown by sex was given for Native Hawaiian or Other Pacific Islander adults in the CDC figures.[23]

Sex

Over 70 million adults in U.S. are obese (35 million men and 35 million women). 99 million are overweight (45 million women and 54 million men).[29] NHANES 2016 statistics showed that about 39.6% of American adults were obese. Men had an age-adjusted rate of 37.9% and Women had an age-adjusted rate of 41.1%.[25]

The CDC provided a data update May 2017 stating for adults 20 years and older, the crude obesity rate was 39.8% and the age adjusted rate was measured to be 39.7%. Including the obese, 71.6% of all American adults age 20 and above were overweight.[30][31]

Age

Historically, obesity primarily affected adults. From the mid-1980s to 2003, obesity roughly doubled among U.S. children ages 2 to 5 and roughly tripled among young people over the age of 6, but statistics show that obesity in 2-6 year olds has dropped, from 14.6% to 8.2%.[32] In recent years from 2015-2016, U.S. adults was 39.8% (crude). Overall, the prevalence among adults aged 40–59 (42.8%) was higher than among adults aged 20–39 (35.7%). No significant difference in prevalence was seen between adults aged 60 and over (41.0%) and younger age groups.[33]

Newborns

Mothers who are obese and become pregnant have a higher risk of complications during pregnancy and during birth, and their newborns are at greater risk for preterm birth, birth defects, and perinatal death. There are more possible risks to children born to obese mothers than pregnant women who are not obese. Newborns are also at risk for neurodevelopmental issues. Obese women are in the position to possibly put their child at risk for compromised neurodevelopmental outcomes. It is not known the whole effect that obesity can have on the neurodevelopmental of the child. Reports concluded that "children born to mothers with gestational diabetes, which is linked with maternal obesity, are at a higher risk for lower cognitive test scores and behavioral problems."[34] Obese women are less likely to breastfeed their newborns, and those who start doing so are likely to stop sooner.[35] Children who were breastfed every extra week by age 2 had a lower chance of being obese. If the hospitals were informative about breastfeeding with mothers or if mothers chose to breastfeed that played a role in the child's weight.[36]

Children and teens

PrevalenceOverweightAge6-19
The rise of overweight among ages 6-19 in the US.

From 1980 to 2008, the prevalence of obesity in children aged 6 to 11 years tripled from 6.5% to 19.6%. The prevalence of obesity in teenagers more than tripled from 5% to 18.1% in the same time frame.[37] In less than one generation, the average weight of a child has risen by 5 kg in the United States.[2] In 2014 it was reported 17.2% of youth aged 2–19 were considered obese and another 16.2% were overweight.[38] Meaning, over one-third of children and teens in the US were overweight or obese. Statistics from a 2016-2017 page on the CDC’s official website that 13.9% of toddlers and children age 2-5, 18.4% of children 6-11, and 20.6% of adolescents 12-19 are obese.[31] The prevalence of child obesity in today's society concerns health professionals because a number of these children develop health issues that weren't usually seen until adulthood.[39]

Some of the consequences in childhood and adolescent obesity are psychosocial. Overweight children and overweight adolescents are targeted for social discrimination, and thus, they begin to stress-eat.[40] The psychological stress that a child or adolescent can endure from social stigma can cause low self-esteem which can hinder a child's after school social and athletic capability, especially in plump teenage girls, and could continue into adulthood.[41] Teenage females are often overweight or obese by age 12, as, after puberty, teenage girls gain about 15 pounds, specifically in the arms, legs, and chest/midsection.

Data from NHANES surveys (1976–1980 and 2003–2006) show that the prevalence of obesity has increased: for children aged 2–5 years, prevalence increased from 5.0% to 12.4%; for those aged 6–11 years, prevalence increased from 6.5% to 19.6%; and for those aged 12–19 years, prevalence increased from 5.0% to 17.6%.[42]

In 2000, approximately 39% of children (ages 6–11) and 17% of adolescents (ages 12–19) were overweight and an additional 15% of children and adolescents were at risk of becoming overweight, based on their BMI.[43]

Analyses of the trends in high BMI for age showed no statistically significant trend over the four time periods (1999–2000, 2001–2002, 2003–2004, and 2005–2006) for either boys or girls. Overall, in 2003–2006, 11.3% of children and adolescents aged 2 through 19 years were at or above the 97th percentile of the 2000 BMI-for-age growth charts, 16.3% were at or above the 95th percentile, and 31.9% were at or above the 85th percentile.[44]

Trend analyses indicate no significant trend between 1999–2000 and 2007–2008 except at the highest BMI cut point (BMI for age 97th percentile) among all 6- through 19-year-old boys. In 2007–2008, 9.5% of infants and toddlers were at or above the 95th percentile of the weight-for-recumbent-length growth charts. Among children and adolescents aged 2 through 19 years, 11.9% were at or above the 97th percentile of the BMI-for-age growth charts; 16.9% were at or above the 95th percentile; and 31.7% were at or above the 85th percentile of BMI for age.[45]

In summary, between 2003 and 2006, 11.3% of children and adolescents were obese and 16.3% were overweight. A slight increase was observed in 2007 and 2008 when the recorded data shows that 11.9% of the children between 6 and 19 years old were obese and 16.9% were overweight. The data recorded in the first survey was obtained by measuring 8,165 children over four years and the second was obtained by measuring 3,281 children.

"More than 80 percent of affected children become overweight adults, often with lifelong health problems."[46] Children are not only highly at risk of diabetes, high cholesterol and high blood pressure but obesity also takes a toll on the child's psychological development. Social problems can arise and have a snowball effect, causing low self-esteem which can later develop into eating disorders.

Adults

There are more obese US adults than those who are just overweight.[47] According to a study in The Journal of the American Medical Association (JAMA), in 2008, the obesity rate among adult Americans was estimated at 32.2% for men and 35.5% for women; these rates were roughly confirmed by the CDC again for 2009–2010. Using different criteria, a Gallup survey found the rate was 26.1% for U.S. adults in 2011, up from 25.5% in 2008. Though the rate for women has held steady over the previous decade, the obesity rate for men continued to increase between 1999 and 2008, according to the JAMA study notes. Moreover, "The prevalence of obesity for adults aged 20 to 74 years increased by 7.9 percentage points for men and by 8.9 percentage points for women between 1976–1980 and 1988–1994, and subsequently by 7.1 percentage points for men and by 8.1 percentage points for women between 1988–1994 and 1999–2000."[48][49] According to the CDC, "obesity is higher among middle age adults, 40-59 years old (39.5%) than among younger adults, age 20-39 (30.3%) or adults over 60 or above (35.4%) adults."[10]

Elderly

Although obesity is reported in the elderly, the numbers are still significantly lower than the levels seen in the young adult population. It is speculated that socioeconomic factors may play a role in this age group when it comes to developing obesity.[50] Obesity in the elderly increases healthcare costs. Nursing homes are not equipped with the proper equipment needed to maintain a safe environment for the obese residents. If a heavy bedridden patient is not turned, the chances of a bed sore increases. If the sore is untreated, the patient will need to be hospitalized and have a wound vac placed.[51]

In the military

An estimated 16% percent of active duty U.S. military personnel were obese in 2004, with the cost of remedial bariatric surgery for the military reaching US$15 million in 2002. Obesity is currently the largest single cause for the discharge of uniformed personnel.[52] A financial analysis published in 2007 further showed that the treatment of diseases and disorders associated with obesity costs the military $1.1 billion annually. Moreover, the analysis found that the increased absenteeism of obese or overweight personnel amounted to a further 658,000 work days lost per year. This lost productivity is higher than the productivity loss in the military due to high alcohol consumption which was found to be 548,000 work days. Problems associated with obesity further manifested itself in early discharge due to inability to meet weight standards. Approximately 1200 military enlistees were discharged due to this reason in 2006.[53]

The rise in obesity has led to less citizens able to join the military and therefore more difficulty in recruitment for the armed forces. In 2005, 9 million adults aged 17 to 24, or 27%, were too overweight to be considered for service in the military.[54] For comparison, just 6% of military aged men in 1960 would have exceed the current weight standards of the U.S. military. Excess weight is the most common reason for medical disqualification and accounts for the rejection of 23.3% of all recruits to the military. Of those who failed to meet weight qualifications but still entered the military, 80% left the military before completing their first term of enlistment.[55] In light of these developments, organizations such as Mission: Readiness, made up of retired generals and admirals, have advocated for focusing on childhood health education to combat obesity's effect on the military.[56]

Prevalence by state and territory

United States Map of Obesity Prevalence by State (2013)
Adult obesity rates in the U.S. by state (2013)
  20.2–24.0%
  24.0–25.0%
  25.0–26.8%
  26.8–28.7%
  28.7–30.4%
  30.4–32.7%
  32.7–34.0%
  34.0–35.2%
Obesity state level estimates 1985-2010
Obesity rates in the U.S. by state (1985–2010)

The following figures were averaged from 2005–2007 adult data compiled by the CDC BRFSS program[57] and 2003–2004 child data[A] from the National Survey of Children's Health.[58][59] There is also data from a more recent 2016 CDC study of the 50 states plus the District of Columbia, Puerto Rico, the U.S. Virgin Islands and Guam.[60]

Care should be taken in interpreting these numbers, because they are based on self-report surveys which asked individuals (or, in case of children and adolescents, their parents) to report their height and weight. Height is commonly overreported and weight underreported, sometimes resulting in significantly lower estimates. One study estimated the difference between actual and self-reported obesity as 7% among males and 13% among females as of 2002, with the tendency to increase.[61]

The long-running REGARDS study, published in the journal of Obesity in 2014, brought in individuals from the nine census regions and measured their height and weight. The data collected disagreed with the data in the CDC's phone survey used to create the following chart. REGARDS found that the West North Central region (North Dakota, South Dakota, Minnesota, Missouri, Nebraska, and Iowa), and East North Central region (Illinois, Ohio, Wisconsin, Michigan, and Indiana) were the worst in obesity numbers, not the East South Central region (Tennessee, Mississippi, Alabama, Kentucky) as had been previously thought.[62] Dr. P.H., professor in the Department of Biostatistics in the UAB School of Public Health George Howard explains that "Asking someone how much they weigh is probably the second worst question behind how much money they make," "From past research, we know that women tend to under-report their weight, and men tend to over-report their height." Howard said as far as equivalency between the self-reported and measured data sets, the East South Central region showed the least misreporting. "This suggests that people from the South come closer to telling the truth than people from other regions, perhaps because there's not the social stigma of being obese in the South as there is in other regions."[63]

The area of the United States with the highest obesity rate is American Samoa (75% obese and 95% overweight).[64]

States, District,
& Territories
Obese adults (mid-2000s) Obese adults (2016)[60][65] Overweight (incl. obese) adults
(mid-2000s)
Obese children and adolescents
(mid-2000s)[66]
Obesity rank
 Alabama 30.1% 35.7% 65.4% 16.7% 3
 Alaska 27.3% 31.4% 64.5% 11.1% 14
 American Samoa 75%[64] 95%[67] 35%[64][68]
 Arizona 23.3% 29.0% 59.5% 12.2% 40
 Arkansas 28.1% 35.7% 64.7% 16.4% 9
 California 23.1% 25.0% 59.4% 13.2% 41
 Colorado 21.0% 22.3% 55.0% 9.9% 51
 Connecticut 20.8% 26.0% 58.7% 12.3% 49
 Delaware 25.9% 30.7% 63.9% 22.8% 22
 District of Columbia 22.1% 22.6% 55.0% 14.8% 43
 Florida 23.3% 27.4% 60.8% 14.4% 39
Georgia (U.S. state) Georgia 27.5% 31.4% 63.3% 16.4% 12
 Guam 28.3% 22%[69]
 Hawaii 20.7% 23.8% 55.3% 13.3% 50
 Idaho 24.6% 27.4% 61.4% 10.1% 31
 Illinois 25.3% 31.6% 61.8% 15.8% 26
 Indiana 27.5% 32.5% 62.8% 15.6% 11
 Iowa 26.3% 32.0% 63.4% 12.5% 19
 Kansas 25.8% 31.2% 62.3% 14.0% 23
 Kentucky 28.4% 34.2% 66.8% 20.6% 7
 Louisiana 29.5% 35.5% 64.2% 17.2% 4
 Maine 23.7% 29.9% 60.8% 12.7% 34
 Maryland 25.2% 29.9% 61.5% 13.3% 28
 Massachusetts 20.9% 23.6% 56.8% 13.6% 48
 Michigan 27.7% 32.5% 63.9% 14.5% 10
 Minnesota 24.8% 27.8% 61.9% 10.1% 30
 Mississippi 34.4% 37.3% 67.4% 17.8% 1
 Missouri 27.4% 31.7% 63.3% 15.6% 13
 Montana 21.7% 25.5% 59.6% 11.1% 45
 Nebraska 26.50% 32.00% 63.90% 11.90% 18
 Nevada 23.6% 25.8% 61.8% 12.4% 36
 New Hampshire 23.6% 26.6% 60.8% 12.9% 35
 New Jersey 22.9% 27.4% 60.5% 13.7% 42
 New Mexico 23.3% 28.3% 60.3% 16.8% 38
 New York 23.5% 25.5% 60.0% 15.3% 37
 North Carolina 27.1% 31.8% 63.4% 19.3% 16
  North Dakota 25.9% 31.9% 64.5% 12.1% 21
 Northern Mariana Islands 16%[70]
 Ohio 26.9% 31.5% 63.3% 14.2% 17
 Oklahoma 28.1% 32.8% 64.2% 15.4% 8
 Oregon 25.0% 28.7% 60.8% 14.1% 29
 Pennsylvania 25.7% 30.3% 61.9% 13.3% 24
 Puerto Rico 30.7% 26%[71][72]
 Rhode Island 21.4% 26.6% 60.4% 11.9% 46
 South Carolina 29.2% 32.3% 65.1% 18.9% 5
 South Dakota 26.1% 29.6% 64.2% 12.1% 20
 Tennessee 29.0% 34.8% 65.0% 20.0% 6
 Texas 27.2% 33.7% 64.1% 19.1% 15
 Utah 21.8% 25.4% 56.4% 8.5% 44
 Vermont 21.1% 27.1% 56.9% 11.3% 47
United States Virgin Islands Virgin Islands (U.S.) 32.5%
 Virginia 25.2% 29.0% 61.6% 13.8% 27
 Washington 24.5% 28.6% 60.7% 10.8% 32
 West Virginia 30.6% 37.7% 66.8% 20.9% 2
 Wisconsin 25.5% 30.7% 62.4% 13.5% 25
 Wyoming 24.0% 27.7% 61.7% 8.7% 33

^ Except territories, whose data is from the late 2000s to 2010s

Epidemiology

Obesity is a chronic health problem. It is one of the biggest factors for a type II diabetes, and cardiovascular disease. It is also associated with cancer (e.g. colorectal cancer), osteoarthritis, liver disease, sleep apnea, depression and other medical conditions that affect mortality and morbidity.[73]

According to the NHANES data, African American and Mexican American adolescents between 12 and 19 years old are more likely to be overweight than non-Hispanic White adolescents. The prevalence is 21%, 23% and 14% respectively. Also, in a national survey of American Indian children 5–18 years old, 39 percent were found to be overweight or at risk for being overweight.[74] As per national survey data, these trends indicate that by 2030, 86.3% of adults will be overweight or obese and 51.1% obese.[75]

A 2007 study found that receiving Food Stamps long term (24 months) was associated with a 50% increased obesity rate among female adults.[76]

Looking at the long-term consequences, overweight adolescents have a 70 percent chance of becoming overweight or obese adults, which increases to 80 percent if one or more parent is overweight or obese. In 2000, the total cost of obesity for children and adults in the United States was estimated to be US$117 billion (US$61 billion in direct medical costs). Given existing trends, this amount is projected to range from US$860.7-956.9 billion in healthcare costs by 2030.[75]

Food consumption has increased with time. For example, annual per capita consumption of cheese was 4 pounds (1.8 kg) in 1909; 32 pounds (15 kg) in 2000; the average person consumed 389 grams (13.7 oz) of carbohydrates daily in 1970; 490 grams (17 oz) in 2000; 41 pounds (19 kg) of fats and oils in 1909; 79 pounds (36 kg) in 2000. In 1977, 18% of an average person's food was consumed outside the home; in 1996, this had risen to 32%.[77]

Contributing factors

Adult female obesity in the United States
Obesity rates of adult females from 1960-2015.

Numerous studies have attempted to identify contributing factors for obesity in the United States. These studies have resulted in numerous hypotheses as to what those key factors are. A common theme is that of too much food and too little exercise, however. Dieting can be useful in lowering someone's body weight, though which foods should be avoided is very confusing to the public. The public has trouble determining what to eat and what not to eat as well as how much or how little they should. For example, while dieting, people tend to consume more low-fat or fat-free products, even though those items can be just as damaging to the body as the items with fat are. As far as the theoretical contributing factor of too little exercise, one contributing factor is that only a small amount, 20%, of jobs require physical activity. Therefore most of our time working is spent sitting.[78]

Adult male obesity in the United States
Obesity rates of adult males from 1960-2015.

Other factors not directly related to caloric intake and activity levels that are believed to contribute to obesity include air conditioning,[79] the ability to delay gratification, and the thickness of the prefrontal cortex of the brain.[80][81] Genetics are also believed to be a factor, with a 2018 study stating that the presence of the human gene APOA2 could result in a higher BMI in individuals.[82] Also, the probability of obesity can even start before birth due to things that the mother does such as smoking and gaining a lot of weight.[78]

Total costs to the US

There has been an increase in obesity-related medical problems, including type II diabetes, hypertension, cardiovascular disease, and disability.[83][14] In particular, diabetes has become the seventh leading cause of death in the United States,[84] with the U.S. Department of Health and Human Services estimating in 2008 that fifty-seven million adults aged twenty and older were pre-diabetic, 23.6 million diabetic, with 90–95% of the latter being type 2-diabetic.[85]

Obesity has also been shown to increase the prevalence of complications during pregnancy and childbirth. Babies born to obese women are almost three times as likely to die within one month of birth and almost twice as likely to be stillborn than babies born to women of normal weight.[86]

Obesity has been cited as a contributing factor to approximately 100,000–400,000 deaths in the United States per year[13] (including increased morbidity in car accidents)[87] and has increased health care use and expenditures,[14][15][16][17] costing society an estimated $117 billion in direct (preventive, diagnostic, and treatment services related to weight) and indirect (absenteeism, loss of future earnings due to premature death) costs.[18] This exceeds health-care costs associated with smoking or problem drinking[17] and, by one estimate, accounts for 6% to 12% of national health care expenditures in the United States[19] (although another estimate states the figure is between 5% and 10%).[88]

The Medicare and Medicaid programs bear about half of this cost.[17] Annual hospital costs for treating obesity-related diseases in children rose threefold, from US$35 million to US$127 million, in the period from 1979 to 1999,[89] and the inpatient and ambulatory healthcare costs increased drastically by US$395 per person per year.[16]

These trends in healthcare costs associated with pediatric obesity and its comorbidities are staggering, urging the Surgeon General to predict that preventable morbidity and mortality associated with obesity may surpass those associated with cigarette smoking.[15][90] Furthermore, the probability of childhood obesity persisting into adulthood is estimated to increase from approximately twenty percent at four years of age to approximately eighty percent by adolescence,[91] and it is likely that these obesity comorbidities will persist into adulthood.[92]

Effects on life expectancy

The United States' high obesity rate is a major contributor to its relatively low life expectancy relative to other high-income countries.[93] It has been suggested that obesity may lead to a halt in the rise in life expectancy observed in the United States during the 19th and 20th centuries.[94][95] In the event that obesity continues to grow in newer generations, a decrease in well being and life span in the future generations may continue to degenerate. According to Olshansky, obesity diminishes "the length of life of people who are severely obese by an estimated 5 to 20 years."[94] History shows that the number of years lost will continue to grow because the likelihood of obesity in new generations is higher. Children and teens are now experiencing obesity at younger ages. They are eating less healthier and are becoming less active, possibly resulting in less time lived compared to their parents' .[94] The life expectancy for newer generations can expect to be lower due to obesity and the health risks they can experience at a later age.

Anti-obesity efforts

The National Center for Health Statistics reported in November 2015:

Trends in obesity prevalence show no increase among youth since 2003–2004, but trends do show increases in both adults and youth from 1999–2000 through 2013–2014. No significant differences between 2011–2012 and 2013–2014 were seen in either youth or adults.[96]

Under pressure from parents and anti-obesity advocates, many school districts moved to ban sodas, junk foods, and candy from vending machines and cafeterias.[97] State legislators in California, for example, passed laws banning the sale of machine-dispensed snacks and drinks in elementary schools in 2003, despite objections by the California-Nevada Soft Drink Association. The state followed more recently with legislation to prohibit their soda sales in high schools starting July 1, 2009, with the shortfall in school revenue to be compensated by an increase in funding for school lunch programs.[98] A similar law passed by the Connecticut General Assembly in June 2005 was vetoed by governor Jodi Rell, who stated the legislation "undermines the control and responsibility of parents with school-aged children."[99]

In mid-2006, the American Beverage Association (including Cadbury Schweppes, Coca-Cola, and PepsiCo) agreed to a voluntary ban on the sale of all high-calorie drinks and all beverages in containers larger than 8, 10 and 12 ounces in elementary, middle and high schools, respectively.[100][101]

Non-profit organizations such as HealthCorps work to educate people on healthy eating and advocate for healthy food choices in an effort to combat obesity.[102]

Former American First Lady Michelle Obama led an initiative to combat childhood obesity entitled "Let's Move". Obama said she aimed to wipe out obesity "in a generation". Let's Move! has partnered with other programs.[103] Walking and bicycling to school helps children increase their physical activity.[73]

In 2008, the state of Pennsylvania enacted a law, the "School Nutrition Policy Initiative," aimed at the elementary level. These "interventions included removing all sodas, sweetened drinks, and unhealthy snack foods from selected schools, 'social marketing' to encourage the consumption of nutritious foods and outreach to parents."[104] The results were a "50 percent drop in incidence of obesity and overweight", as opposed to those individuals who were not part of the study.[104]

In the past decade there have been school-based programs that target the prevention and management of childhood obesity. There is evidence that long term school-based programs have been effective in reducing the prevalence of childhood obesity.[105]

For two years, Duke University psychology and global health professor Gary Bennett and eight colleagues followed 365 obese patients who had already developed hypertension. They found that regular medical feedback, self-monitoring, and a set of personalized goals can help obese patients in a primary care setting lose weight and keep it off.[106]

Major United States manufacturers of processed food, aware of the possible contribution of their products to the obesity epidemic, met together and discussed the problem as early as April 8, 1999; however, a proactive strategy was considered and rejected. As a general rule, optimizing the amount of salt, sugar and fat in a product will improve its palatability, and profitability. Reducing salt, sugar and fat, for the purpose of public health, had the potential to decrease palatability and profitability.[107]

Media influence may play an important role in prevention of obesity as it has the ability to boost many of the main prevention/intervention methods used nowadays including lifestyle modification. The media is also highly influential on children and teenagers as it promotes healthy body image and sets societal goals for lifestyle improvement. Examples of media influence are support for the "Let's Move!" campaign and the MyPlate program initiated by Michelle Obama, and the NFL's Play60 campaign. These campaigns promote physical activity in an effort to reduce obesity especially for children.[108]

In 2011 The Obama Administration introduced a $400 million Healthy Food Financing Initiative, the goal of the program is to "create jobs and economic development, and establish market opportunities for farmers and ranchers," as described by the secretary of agriculture, Tom Vilsack.[109]

Food labeling

Ultimately, federal and local governments in the U.S. are willing to create political solutions that will reduce obesity ratings by "recommending nutrition education, encouraging exercise, and asking the food and beverage industry to promote healthy practices voluntarily."[104] In 2008, New York City was the first city to pass a "labeling bill" that "require[d] restaurants" in several cities and states to "post the caloric content of all regular menu items, in a prominent place and using the same font and format as the price."[104]

Accommodations

[110] Along with obesity came the accommodations made of American products. Child-safety seats in 2006 became modified for the 250,000 obese U.S. children ages six and below.[111] The obese incur extra costs for themselves and airlines when flying. Weight is a major component to the formula that goes into the planes take off and for it to successfully fly to the desired destination. Due to the weight limits taken in consideration for flight in 2000, airlines spent $275 million on 350 million additional gallons of fuel for compensation of additional weight to travel.[111] Accommodations have also been made in work place environments for workers, including those such as chairs with no armrests and access to work outside of the office.[112]

See also

Documentaries:

References

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External links

Carol Yager

Carol Ann Yager (January 26, 1960 – July 18, 1994) was an American woman who was the heaviest woman ever recorded and one of the most severely obese people in history.

Celebrity Fit Club (U.S. TV series)

Celebrity Fit Club is a reality television series which followed eight overweight celebrities as they tried to lose weight.

This show is based on the homonymous British version, which aired on the ITV Network from 2002 until 2006. The American version was executive produced by Richard Hall for Granada, in seasons 2–5.

Childhood obesity

Childhood obesity is a condition where excess body fat negatively affects a child's health or well-being. As methods to determine body fat directly are difficult, the diagnosis of obesity is often based on BMI. Due to the rising prevalence of obesity in children and its many adverse health effects it is being recognized as a serious public health concern. The term overweight rather than obese is often used when discussing childhood obesity, especially in open discussion, as it is less stigmatizing.

Fed Up (film)

Fed Up is a 2014 American documentary film directed, written and produced by Stephanie Soechtig. The film focuses on the causes of obesity in the US, presenting evidence showing that the large quantities of sugar in processed foods are an overlooked root of the problem, and points to the monied lobbying power of "Big Sugar" in blocking attempts to enact policies to address the issue.

Jon Brower Minnoch

Jon Brower Minnoch (September 29, 1941 – September 10, 1983) was an American man who, at his peak weight, was the heaviest human being ever recorded, weighing approximately 1,400 lb (635 kilograms; 100 stone). This figure was only a close estimation because his extreme size, declining health, and lack of mobility prevented use of a scale.

Laurie David

Laurie Ellen David (née Lennard; born March 22, 1958) is an American environmental activist. She produced the Academy Award-winning An Inconvenient Truth and, most recently, teamed up with Katie Couric to executive produce Fed Up, a film about the causes of obesity in the United States. She serves as a trustee on the Natural Resources Defense Council and a member of the Advisory Board of the Children's Nature Institute and is a contributing blogger to The Huffington Post.

Let's Move!

Let's Move! was a public health campaign in the United States, led by Michelle Obama, wife of then-President Barack Obama. The campaign aims to reduce childhood obesity and encourage a healthy lifestyle in children.The initiative has the initially stated goal of "solving the challenge of childhood obesity within a generation so that children born today will reach adulthood at a healthy weight." Let's Move seeks to decrease childhood obesity to 5% by 2030.

Mikel Ruffinelli

Mikel Ruffinelli (born 1972) is an American woman who currently holds the record of widest hip in the world, according to the World Record Academy. Her weight is more than 420 pounds (190 kg) and her hips measures an unusual 8 feet (2.4 m) in circumference, although her waist is only 3 feet 4 inches (102 cm). She is 5 feet 4 inches tall.

Mo'Nique's Fat Chance

Mo'Nique's Fat Chance was a reality TV miniseries. It featured 10 plus-sized women competing in a beauty pageant to become "Miss F.A.T.," which is explained as "Fabulous and Thick." It is hosted by actress Mo'Nique and has aired since 2005 on the Oxygen network.

My 600-lb Life

My 600-lb Life is a reality television series that has aired on the TLC television network since 2012. Each episode follows a year in the life of morbidly obese individuals, who begin the episode weighing at least 600 pounds (270 kg), and documents their attempts to reduce their weight to a healthy level. Update episodes, called "Where Are They Now?", feature one or more previous patients, picking up a year or more after their original episodes aired.

Patients are placed under the care of Iranian-American Houston surgeon Younan Nowzaradan (often referred to as simply "Dr. Now"), who first has them attempt losing weight on their own by following a strict diet, and then depending on the patient's progress may offer gastric bypass surgery or sleeve gastrectomy to further assist in weight loss.

My Diet Is Better Than Yours

My Diet Is Better Than Yours is an American reality competition television series which premiered on ABC on January 7, 2016. The weight-loss series features five contestants who each picks a trainer and a type of diet that they believe are the most suitable for them; the competitors subsequently drop their trainers in the elimination process if the results are not satisfactory.

Renee Williams

Renee Williams (June 4, 1977 – March 4, 2007) was an American woman believed to be the largest woman in the world at the time of her death in 2007 from complications following her surgery for morbid obesity. Williams was also one of the heaviest people to ever live.

Robert Earl Hughes

Robert Earl Hughes (June 4, 1926 – July 10, 1958) was an American man who was, during his lifetime, the heaviest human being recorded in the history of the world.Robert Earl Hughes was born on June 4, 1926 in Monticello, Missouri, the son of Abraham Guy Hughes (1878–1957) and Georgia Alice Weatharby (1906–1947). He had two younger brothers, Guy B. Hughes (1927–2006), and Donald Hughes (1929–2012). At the age of six, Robert weighed about 92 kilograms (203 lb); at twelve, he weighed 148 kilograms (326 lb). His excessive weight was attributed to a malfunctioning pituitary gland. His chest was measured at 3.15 metres (10.3 ft), and he weighed an estimated 485 kilograms (1,069 lb) at his heaviest.

During his adult life, Hughes made guest appearances at carnivals and fairs; plans to appear on the Ed Sullivan television program were announced but never came about. On July 10, 1958, Hughes contracted a case of measles, which soon developed into uremia, resulting in his death in Bremen, Indiana, United States. He was 32 years old. He is buried in Benville Cemetery, Brown County, Illinois.

It is often said he was buried in a piano case. This error stems from a sentence that appeared in successive editions of the Guinness Book of World Records, which read, "He was buried in a coffin the size of a piano case." His headstone notes that he was the world's heaviest man at a confirmed 1,041 pounds (472 kg).

Task Force on Childhood Obesity

The Childhood Obesity Task Force is a United States Government task force charged with reducing childhood obesity in the United States. It was founded on February 9, 2010 by the Obama Administration through a Presidential Memorandum, announcing the establishment of a Task Force on Childhood Obesity. The Task Force aims to develop a plan to reduce childhood obesity. In the announcement, President Barack Obama highlighted the statistics on childhood obesity in the United States and outlined the steps that this new task force would be taking to end childhood obesity. Section 1 of the Memorandum states:

There is established a Task Force on Childhood Obesity (Task Force) to develop an interagency action plan to solve the problem of obesity among our Nation's children within a generation. The Assistant to the President for Domestic Policy shall serve as Chair of the Task Force.

The task force is designed to support the Administration's "Let's Move" initiative, first announced by Michelle Obama in February 2010. The Let's Move initiative is similar to the task force, except it focuses on involving more partners in the cause to reduce childhood obesity than just the United States Government.

Team Tiger

Team Tiger is an Atlanta-based certified 501(c)3 organization whose mission is to help kids and families fight childhood obesity. The organization provides the resources, opportunity, education and support.Team Tiger is led by young founder Tiger Greene, who, as a twelve-year-old boy, weighed 250 pounds (twice the normal weight for a child his age). Tiger was bullied for his weight and had trouble with simple everyday tasks. By making lifestyle changes and learning about healthy food and exercise, Tiger lost over 60 pounds. Tiger has become a national spokesperson for this curable epidemic. He has been featured on national television programs, including: Dr. Oz, CNN’s Dr. Sanjay Gupta, Anderson Cooper 360, NBC and ABC affiliates and was a featured speaker at the Georgia Children’s Health Alliance ‘Refocus’ Launch.Following his love of football, Tiger partnered with the NFL, including player Marcus Stroud. Together they started a series of fitness camps to inspire thousands of young people to lose weight and get more active. These Sacking Obesity Health & Wellness Camps are run by Team Tiger and the Marcus Stroud Charitable Foundation.

Tiger Greene's Sacking Obesity: The Team Tiger Game Plan for Kids Who Want to Lose Weight, Feel Great, and Win on and off the Playing Field is a book published by HarperCollins Publishers that puts the camp experience into a book. It includes menu plans, exercise routines, and inspirational stories about kids who have decided to make good choices in their lives.On Wednesday, September 19, 2012, Governor Nathan Deal of Georgia declared "Team Tiger Day" in the State of Georgia.

The Biggest Loser (U.S. TV series)

The Biggest Loser is an American competition reality show that has run on NBC for 17 seasons, from 2004 to 2016. The show features obese or overweight contestants competing to win a cash prize by losing the highest percentage of weight relative to their initial weight.

The Biggest Loser has been fairly popular for some of its run, ranking among the top 50 shows in the United States from 2004 to 2005 and again from 2009 to 2011. It has also attracted significant controversy, including both general critiques of its approach of rapid weight loss, and specific allegations that contestants have been malnourished, dehydrated, overexerted and, in some cases, been given weight loss pills, in order for them to lose as much weight as possible.

The Biggest Loser format has been highly popular around the world, spawning over 30 international adaptations, some of which remain on the air.

On May 13, 2019, it was announced that a reboot of the show will premiere in USA Network in 2020.

West Virginia Healthy Lifestyles Act of 2005

The West Virginia Healthy Lifestyles Act of 2005 is a West Virginia state law enacted in 2005. Signed into law by Governor Joe Manchin III, the act's purpose was to address obesity in the state. The state legislature found in 2005 that "obesity is a problem of epidemic proportions" in West Virginia.

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